An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored.A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure.Pharmacological sphincterotomy using Glyceryl trinitrate , Isosorbide dinitrate or calcium channel blockers are exciting alternative treatment , that relaxes the anal sphincter and, therefore, promote healing, the drawback of such medications are headache and poor compliance. With the introduction of Botulinum toxin as mean of chemical sphincterotom, topical injection of Botulinum toxin reduces the anal hypertonia which lasts for few months, allows the fissure to heal, thus eliminating the need for surgery without incidence of incontinence. Cure rates are over 60%, and the procedure can be repeated safely. Therefore, Botulinum toxin is a reasonable first-line management of chronic anal fissure and the relapses can be managed by surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The love of the world and its lusts are the head of sins and the corruptors of religion, and the one who loves and loves them who prefers them over the hereafter is one of the most pitiful of creation, and the least intelligent of them, as he prefers imagination over reality, sleep over wakefulness, fleeting shadow over eternal bliss and the mortal abode over the eternal abode, and he sold the life of eternity for the most luxurious life. In life, it is dreams and sleep or as a fleeting shadow, and as it was said: The intelligent person is not deceived.
The reason for choosing this topic is due to two things:
The first: When I contemplated the reasons for the differences and conflicts that afflicted our wounded and occupied country
The study objective was to conduct Pharmacoeconomics study (cost-effective analysis) between infliximab reference (Remicade) and its biosimilar (Remsima) in patients with rheumatoid arthritis (RA) in Iraqi hospitals.
This is a retrospective multicenter pharmacoeconomic analysis conducted at two large teaching governmental hospitals in Baghdad, Iraq which provided infliximab to patients with RA. Data were collected from patient’s medical records and face-to-face interviews with the patients from December 2021 to April 2022.
The study included 57 patients with rheumatoid arthritis (RA). The patients were categorized into two groups according to the type of infliximab they received over 30 weeks: 27 patients received
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Background: Schneiderian first rank symptoms are
considered highly valuable in the diagnosis of
schneideria.
They are more evident in the acute phase of the
disorder and fading gradually with time. Many studies
have shown that the rate of these symptoms are
variable in different countries and are colored by
cultural beliefs and values.
Objectives: To find out the rate of Schneiderian first
rank symptoms among newly diagnosed schizophrenic
patients, to assess which symptom(s) might
predominate in those patients, and to find out if there
is/are any correlation(s) between the occurrence of
these symptoms and the sex of the patients.
Methods: Out of twenty-four patients with no past
psychiatric hi
الملخص ان حق الملكية هو الحق الاوسع نطاقا يمنح صاحبه صلاحية ممارسة السلطات كافة ويكون محل هذه السلطات كل ما يملك الشخص سواء كان شقه او طبقة اسوة بالعقارات الاخرى كدار للسكن او ارض ، ومن اهم هذه السلطات واوسعها نطاقا ( هو سلطة التصرف ). تعد هذه السلطة جوهر حق الملكية وأخطر السلطات الممنوحة للمالك كونه بواسطتها يمكنه الاستغناء عن ملكه بأي تصرف ناقل له كالبيع أو الهبة او الوصية مثلا ، ولأهمية هذه السلط
... Show MoreThe current research aims to determine the requirements of Trends of International Mathematics and Science Study (TIMSS 2019) and to find out the extent to which the content of science textbooks for grades (1-4) in the Sultanate of Oman includes the requirements of (TIMSS 2019). Only the Cognitive Process dimension has been considered when conducting the analysis. The study population includes all science books from the first to the fourth grade for the academic year 2021-2022. The study identified and organized the requirements in the study tool, which is a list of requirements of (TIMSS 2019). After confirming its validity and reliability, the analysis was performed, and data were collected and analyzed statistically using frequencies
... Show MoreIt is necessary to use the means of recovery and other means that help to get rid of the effects of fatigue, as the game of badminton and the effectiveness of running 800 meters fall within the mixed system with the superiority of the anaerobic system by more than the air system, so requires the development of energy systems In proportion to the time of the match for badminton players and their travels and high performance and ability to tolerate the high level of lactic acid in the muscles and blood and increase the pain associated with the fatigue that occurs during the performance. In light of the physical and physiological processes of these actions N it should seek through training programs to develop your endurance and wind energy sys
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Electrical magnate was designed and constructed, the optimum Magnetic flux and the effect of time on the physical properties of the alkaline (magnetic water) produced from the bottled drinking water [the total dissolved solids (TDS) or the electrical conductivity, and pH] were studied, to simulate ZamZam water in Mekka Saudi Arabia. Also, the efficiency of magnetic field from this designed electrical magnate in decreasing the TDS of sea water (of 1500 ppm NaCl Content), to convert it to water suitable for irrigation (TDS<1000 ppm) was investigated in this work.The results show that the magnetic flux from our designed electrical magnate in the range of (0.013- 0.08) Tesla and 30 minut
... Show MoreThe post-Corona Covid-19 world is not the world before it, the problem of perception of personality traits with two axes: the characteristics of psychological and social compatibility, and the second aspect the mental disorder during the pandemic, and the accompanying precautions and prohibitions during the academic year 2020 AD. The aim of the research is to reveal the perception of the personal characteristics of Bisha University employees (students and faculty) during the Corona Covid-19 pandemic, and to reveal statistically significant differences in the perception of the personality traits of Bisha’s members during the Covid 19 according to the scientific qualification variables (female students -faculty members), marital st
... Show MoreIraq has the second largest proven oil reserves in the world. According to oil experts, it is expected that the Iraq's reserves to rise to 200+ billion barrels of high-grade crude.
Oil is a strategic commodity for producing and exporting countries in general, and Iraq in particular, as demonstrated by the international experience that oil is an important means to achieve economic growth, an important tool in the overall economic, social and political development. It is also an important source of hard currency for any national economy and a means to connect the local economy and the global economy. In this paper we focus our attention on selecting the best regression model that explain the effect of human capita
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